PURPOSE: The aim of this study was to explain the experiences of Iranian nursing students regarding their clinical learning environment (CLE). METHODS: Twenty-one nursing students participated in this qualitative study. Data were collected using semistructured interviews and analyzed using conventional content analysis. RESULTS: Analysis of interviews identified six categories: educational confusion, absence of evaluation procedures, limited educational opportunities, inappropriate interactions with nursing staff, bullying culture, and discrimination. Systematic and consistent methods were not used in clinical education and evaluation of nursing students. In addition, there were inadequate interactions between nursing students and health-care staff, and most students experienced discrimination and bullying in clinical settings. CONCLUSION: Findings showed that the CLE of Iranian nursing students may be inadequate for high-level learning and safe and effective teaching. Addressing these challenges will require academic and practice partnerships to examine the systems affecting the CLE, and areas to be addressed are described in the six themes identified.
Bullying ; Discrimination (Psychology) ; Education ; Education, Nursing ; Humans ; Iran ; Learning* ; Nursing Staff ; Nursing* ; Qualitative Research ; Students, Nursing*

PURPOSE: To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas. METHODS: The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals. RESULTS: Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree. CONCLUSION: Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.
Adult ; Attitude of Health Personnel ; Education, Nursing, Baccalaureate ; Employment ; Female ; Hospitals, Rural ; Hospitals, Urban ; Humans ; Logistic Models ; Male ; Nursing Staff, Hospital/*psychology ; Poverty ; Professional Practice Location

PURPOSE: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. METHODS: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. RESULTS: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. CONCLUSION: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.
Adult ; Attitude of Health Personnel ; *Drug Resistance, Multiple, Bacterial ; Female ; Guideline Adherence ; *Health Knowledge, Attitudes, Practice ; Hospitals, University ; Humans ; Infection Control/methods/*standards ; Nursing Staff, Hospital/education/*psychology ; Practice Guidelines as Topic ; Questionnaires

PURPOSE: To develop a web-based program on blood-borne infection control and to examine the effect of the newly developed program on perceived threat of diseases, knowledge, preventive health behaviors for blood-borne infections, and incidence rates of accidental needle sticks and other sharp object injuries in nurses. METHODS: The program was developed through the processes of analysis, design, development, implementation, and evaluation. The research design involved a nonequivalent control group for pretest and posttest experiments. The setting was a 745-bed general hospital located in Korea. RESULTS: The program was designed and developed after consulting previous studies. After development of the program was completed, it was evaluated and revised by a panel of experts. The total score for perceived threat of diseases, knowledge, preventive health behaviors in the experimental group was significantly higher compared to the control group (p<.05). The incidence rates for needle sticks and other sharp object injuries in the experimental group were significantly lower compared to the control group (p<.05). CONCLUSION: Application of a Web-based, blood-borne infection control program is effective, and can be expanded to other healthcare workers who also have a high risk of blood-borne infections.
Adult ; *Blood-Borne Pathogens ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infection Control/*methods ; *Internet ; Needlestick Injuries ; Nursing Staff, Hospital/education/*psychology ; Occupational Exposure/*prevention & control ; Questionnaires

PURPOSE: This study was done to compare edema and pain after completing a nurse's daily shift and to examine the effects of self leg massage which was usually used for reducing nurses' lower extremity edema and pain after their shift. METHODS: The research design was a nonequivalent control group pretest-posttest design. Study subjects wer 81 nurses who took a self leg massage program created by the researcher. Self leg massage was done 15 times during 3 weeks. Data were collected from September 21 to October 31, 2007. The level of lower extremity edema was measured by ankle and calf circumference by a tapeline in cm and the pain score was measured by using a subjective numbering rating scale. Data were analyzed with the SPSS 12.0 program using statistics of repeated measures ANOVA. RESULTS: There was a statistically significant difference in pain according to the department. There was a statistically significant difference in lower extremity edema and pain in nurses after their shift and self leg massage. CONCLUSION: Self leg massage was effective for relieving nurses' lower extremity edema and pain. Therefore, it is proposed that standardized self leg massage should be applied as a method for nurses' lower extremity edema and pain.
Adult ; Edema/*therapy ; Education, Nursing, Continuing ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; *Leg/physiology ; *Massage ; Nursing Staff, Hospital/*psychology ; Pain/*therapy ; Pain Measurement ; Self Care ; Young Adult

PURPOSE: This study was to analyze the sustainable effects of cardiopulmonary resuscitation (CPR) reeducation on nurses' knowledge and skills. METHODS: A repeated experimental design was used for a single sample group of 47 nurses working for a general hospital. The nurses were tested on their skill of CPR 3 times at an interval of 4 months. In order to test nurses' knowledge and skills, the researcher used a CPR assessment program linked to an adult practice doll (Anne). RESULTS: 1) The amount of decrease of nurses' knowledge about CPR between points of time was wide between the first and second points of time but small between the second and third time owing to the effects of reeducation between the two points of time. 2) Nurses' skills between the first and second time dropped but they improved between the second and third time owing to the effects of reeducation. CONCLUSION: As confirmed by the above findings, reeducation of CPR clearly affects nurses' knowledge and skills. Given the fact that the same period of time (4 months) elapsed between the 3 tests, it could be argued that the reeducation at the second test served to maintain nurses' knowledge and enhance their skills.
Adult ; Cardiopulmonary Resuscitation/*education/nursing ; *Clinical Competence ; Cognition ; Education, Professional, Retraining ; Emergency Medical Services ; *Health Knowledge, Attitudes, Practice ; Humans ; Nursing Staff, Hospital/*education/psychology ; Retention (Psychology)

PURPOSE: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. METHOD: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. RESULTS: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored: greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. CONCLUSION: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.
*Communication ; Drug Therapy/*psychology ; Humans ; Internal Medicine ; Nurse's Role/*psychology ; *Nurse-Patient Relations ; Nursing Care ; Nursing Education Research ; Nursing Staff, Hospital/*psychology ; Tape Recording

PURPOSE: The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. METHOD: A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. RESULTS: The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. CONCLUSION: There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.
*Assertiveness ; *Attitude of Health Personnel ; Communication ; Conflict (Psychology) ; Female ; Humans ; Inservice Training/methods ; Interpersonal Relations ; Nursing Staff, Hospital/education/*psychology ; *Personnel Turnover ; Program Evaluation

PURPOSE: The purposes of this study were to develop a PBL program for continuing nurse education and to evaluate the program after its implementation. METHODS: The PBL program was developed in the core cardio-pulmonary nursing concepts through a collaborative approach with a nursing school and a hospital. The PBL packages with simulation on ACLS were implemented to 40 clinical nurses. The entire PBL program consisted of six 3-hour weekly classes and was evaluated by the participants' subjective responses. RESULTS: Two PBL packages in cardio-pulmonary system including clinical cases and tutorial guidelines were developed. The 57.5% of the participants responded positively about the use of PBL as continuing nurse education in terms of self-motivated and cooperative learning, whereas 20.0% of the participants answered that the PBL method was not suitable for clinical nurses. Some modifications were suggested in grouping participants and program contents for PBL. CONCLUSION: The PBL method could be utilized to promote nurses' clinical competencies as well as self-learning abilities. Further research is needed in the implementation strategies of PBL-based continuing education in order to improve its effectiveness.
Adult ; Attitude of Health Personnel ; Cardiology/education ; *Clinical Competence ; Computer Simulation ; Curriculum ; Education, Nursing, Continuing/*organization & administration ; Health Services Needs and Demand ; Heart Diseases/nursing ; Hospitals, University ; Humans ; Lung Diseases/nursing ; Manikins ; Middle Aged ; Nursing Education Research ; Nursing Methodology Research ; Nursing Staff, Hospital/*education/psychology ; Organizational Objectives ; Pilot Projects ; Problem-Based Learning/*organization & administration ; Program Development ; Program Evaluation ; Pulmonary Medicine/education

PURPOSE: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. METHOD: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. RESULTS: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were not confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. CONCLUSION: The results support the strong need for development of a multi-component educational program on delirium care.
Adult ; Delirium/*nursing/psychology ; Female ; Hospitals, University ; Humans ; Male ; Models, Nursing ; Nursing Staff, Hospital/education/*psychology ; Program Evaluation ; Qualitative Research ; Questionnaires